Individual provider Active NPI

John David Stock, PT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1194749887
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05006033A Issued in IN
Practice address
14020 Old State Rd # D100
Evansville, IN 47725-1164
Phone
(812) 469-4770
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05006033A IN Primary

Addresses

Primary practice location

14020 Old State Rd # D100
Evansville, IN 47725-1164

Mailing address

5927 Reliable Pkwy
Chicago, IL 60686-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809002586 IN Practitioner - Physical Therapist in Private Practice 2466723432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Health IncGroup PAC ID 9133023898, 53 clinicians

Practice addresses (Care Compare)

14020 Old State Rd
Suite D100
Evansville, IN 47725-1164
Phone (812) 469-4470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Health, Inc Physical Therapist Current Accepting new patients

Locations

5927 Reliable Pkwy
Chicago, IL 60686

14020 Old State Rd
Ste D100
Evansville, IN 47725
Phone (812) 469-4470

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

1144 Washington Sq
Evansville, IN 47715
Phone (812) 485-5200

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1194749887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5927 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14020 OLD STATE RD # D100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477251164",
            "telephone_number": "812-469-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006033A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.